Summary of the Training Programme

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The training programme should be largely student or trainee-centred but active trainer involvement is essential.  The syllabus is clearly detailed in the logbook but it is very much up to the trainee to target what they need to learn. There needs to be interaction between the trainees and trainers and regular formative review and feedback is important.  Whilst the practical aspects of colposcopy are learnt via apprenticeship, there is a difference between clinical supervision and tuition; trainers should not function simply as overseers should actively be tutors, providing direction and assessment in training. Much of the theoretical background to colposcopy is initially introduced by gathering information.  However the integrated nature of the clinical training strongly enables problem-based learning.  Each case presents an individual problem, which acts as a stimulus for learning.  Trainees should consider what and why they do what they do and this practical experience should be supplemented by focused background reading in order to put cases into perspective.

Basic Colposcopy Course

All trainees must have completed a BSCCP-recognised Basic Colposcopy Course, preferably, prior to starting clinical colposcopy training.  However, this may be at a later date, after training has commenced, if the Trainer has no objection

Clinical experience

It is recommended that clinical training should be completed within 12 months.  The trainee is required to see 50 cases (20 of which must be new cases) under direct supervision and 100 (30 new) cases under indirect supervision.  Half of all new cases must be high-grade smear referrals.
Direct supervision means that the colposcopic examination is performed with the trainer in the room.  Indirect supervision is when the trainee is seeing a patient without the trainer present in the room.  However, the trainer should be available if needed.  The trainer should review every case seen by the trainee, ideally straight after each clinical session so as to provide feedback.

Multidisciplinary Team Meetings

Trainees should regularly attend MDT meetings in their unit, and as a minimum, should attend at least 50% (a minimum of 6) of the meetings during their period of training.

The Log-Book

This has a number of educational roles and should not simply be regarded as a record.  Firstly it documents the trainee’s progress in working through the theoretical aspects of colposcopy: the trainer should regularly review this with the trainee to identify if there are any problem areas.  In addition, the log-book records clinical experience and it is important that the trainer periodically reviews this in order to assess breadth of experience and to overview the correlation between colposcopic findings and histology.
Completion of the logbooks is on-line only.

Electronic Colposcopy Logbook Minimum Requirements:
50 cases performed under direct supervision:
20 must be NEW cases, (10 of these must be HIGH GRADE)
30 review cases
100 cases performed under indirect supervision:
30 must be NEW cases, (15 of these must be HIGH GRADE)
70 review cases

When Review cases are not available it is possible to enter NEW cases in as REVIEW cases

Audit/Research

Trainees should be encouraged to undertake at least one audit topic during their training, whether or not they had previous audit experience.  Wherever possible they should be encouraged to participate in research studies.

Pathology Experience

All trainees should be familiar with the workings of the cyto- and histopathology laboratories and spend at least one session of 5 hours in each. Nurse trainees must dedicate 3 sessions of 5 hours each to cytopathology and histopathology. In addition all trainees should attend clinico-pathological meetings.
The aims of Colposcopy Trainees attending Pathology Laboratories are:
• To understand the practical aspects of slide preparation
• To view cytology slides
• To see how loop specimens are handled grossly
• To see how poor biopsy techniques result in problems of interpretation
• Meet the Cytology and Pathology Staff and gain an understanding of their work
Click to download the Laboratory Attendance form

Communication

Good communication skills are key competences for a colposcopist.  Ideally all trainees should have attended a communications skills course at some point in their professional training.